Prevalence of depression in pediatric patients with diagnosed or at high risk for obstructive sleep apnea: A systematic review with meta-analysis.

Obstructive sleep apnea (OSA) may increase the risk of depression through various hypothesized mechanisms. Studies regarding this relationship with children are limited. This systematic review aims to assess the prevalence of depression in pediatric patients with OSA. Five electronic databases, grey literature, and reference lists of included studies were systematically searched. Studies reporting the prevalence of depression, as described by the Diagnostic and Statistical Manual of Mental Disorders (DSM), psychiatric evaluation or other validated screening measures, in children with OSA diagnosed by polysomnography (PSG), or at high risk for OSA based on positive scores on other validated measures were included. The risk of bias was performed using the Joanna Briggs Institute (JBI) Checklist for cross-sectional studies. Six studies from three countries and over 2300 pediatric patients were included. This meta-analysis showed an overall 28 % prevalence of depression among children with OSA or at high risk for OSA, which is almost two-fold higher than among children without OSA (controls). Overall, this meta-analysis suggests that around one out of every four children with or at high risk for OSA could have depression, and one in 10 children if OSA has been confirmed by PSG. Screening of OSA in pediatric patients with symptoms of depression and vice versa, screening of depressive symptoms in children with suspected or confirmed OSA, may be valuable areas of focus for multidisciplinary preventative care to optimize psychiatric treatment.